Insurance Form

Customer Information
Company Name
Address
Country
Contact Name
Contact E-mail
Contact Phone
Insurance - Options
1.- All shipments are insured directly by us: We have inbound transportation insurance and require no additional insurance. We understand that any loss or damage during transit from TNI to our company is our responsibility. We are liable for the payment to TNI for 100% of invoice value. (Please complete the information on Section "Existent Insurance Policy")
2.- We do not require insurance for any of our shipments: We do not have inbound transportation insurance. However, we request that TNI does not insure our packages. We understand that any loss or damage during transit from TNI to our company is our responsibility. We are liable for the payment to TNI for 100% of invoice value.
3.- We require insurance thru TNI: We do not have inbound transportation insurance. Please insure our shipments and charge our account accordingly.
Existent Insurance Policy
Insurance Company
Policy #
Expiration Date

By signing this form you confirm that all information provided is true and correct. The submission of this form will be received by TNI and will be considered a legal document. A copy of this submission will be forwarded to you as a confirmation

Signature
(First and Last Name)
Job Title

 

Copyright © 2004 TNI Technologies, Inc. All rights reserved              User Agreement               Privacy Policy